Social Question

jca's avatar

Stemming from the massacre in Newtown CT: What do you think should be done about the issue of the severely mentally ill receiving treatment for their illness, both for their own sake and for the benefit of society?

Asked by jca (27898 points ) December 18th, 2012

Yesterday I asked a question about the necessity of people needing semi automatic weapons, based upon the recent tragedy in Newtown CT where an entire kindergarten class was killed by an apparently mentally ill man with a semi automatic weapon. What is being investigated is the mental state of the murderer and whether or not he received any kind of treatment. I see on the news right now they said he was assigned a psychologist at Newtown High School but when he left school, his treatment was ended and he did not receive any treatment after that.

In addition to current debates about gun control which stem from this massacre, the other side of the coin is the issue of mental health treatment for severe mental illness. How could we ensure that someone who needs mental health treatment receives it? Many people do not have any health insurance or Medicaid. In the municipality that I work for (a County government), the current administration is popular with some for keeping taxes down (in a county that already pays very high taxes). Workers are facing layoffs as we speak. In order to “ensure” that someone receives mental health treatment, it would be very time consuming and expensive to keep track of them. There are no guarantees that someone is taking their prescribed medications. If people need to go elsewhere for treatment, they may have transportation issues, they may simply not want to go or may not feel they need treatment, and they wouldn’t pursue it, and to ensure that they pursue it is the hard part. Should each person with severe mental illness (I am referring to diagnoses such as schizophrenia) be assigned a caseworker in the community? Even with someone tracking a patient, it would be impossible to ensure that the person is receiving psychiatric help and taking their medications. Patients can’t be forced to take medications if they choose not to.

In discussing this with a friend last night, he suggested that if people don’t go for their treatment, “we should just lock them up in mental hospitals.” Citizens have rights, and unless it’s determined by a professional that someone is a danger to themselves or others, we can’t just round people up and lock them up. “Locking people up in mental hospitals” is very expensive and impractical. With modern psychiatric medications that have been introduced and improved since the 1960’s, the goal has been to close mental institutions and have people living in their communities, not to be institutionalized.

Any suggestions?

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93 Answers

elbanditoroso's avatar

I’m not sure what should be done, because I’m not a mental health expert.

But I would caution against some sort of “he doesn’t want treatment, so let’s lock him up” mentality. I think that opens the door to all sorts of abuse by powerful people—it could easily be stretched by political forces to mean “You don’t like Reaganomics? You must be sick, so let’s lock you up in a mental hospital!”.

I’m very wary of forced confinement for people who are simply not in tune with the rest of the population.

Mental health care has never been a priority in the US—primarily due to cost. In the current political environment, it is much easier to get money for planes and guns than doctors and psychologists. While it might be good to have 100,000 more mental health counselors (of course it will take 20 years to train that many), there will never be the funding to make it possible. It’s just not the American way.

Finally, I also worry about the squishy definition of mental illness. I would say that 98% of the population—you, me, and all of our neighbors – could be described as having one sort of mental illness/disorder/syndrome or another. Mostly minor, and mostly well compensated for, but—none of us are without issues.

jca's avatar

@elbanditoroso: I specified that my question was referring to “severe” mental illness, such as schizophrenia.

elbanditoroso's avatar

Thats one of the problems, @jca. Severity is a judgment call. Yes, there are clinical definitions but there are also political pressures to make those definitions fit an agenda.

In other words, what you call mild someone else can call severe. That’s why opening the door to that sort of thing is dangerous.

marinelife's avatar

The mentally ill used to “just be locked up”, but the Supreme Court decided that that violated their rights.

Monitoring them and whether they take their medication is beyond us at this moment in terms of cost and technology,

What we can do to ensure public safety is make sure that untreated mentally ill people don’t have access to guns.

bookish1's avatar

@jca: Thanks very much for starting this conversation.

I’ve been trying not to OD on the news coverage of this. Do investigators really think that he had something like schizophrenia? Last I heard, he was believed to be somewhere in the autistic spectrum, which is not a mental illness in my understanding, so I’m confused now.

KNOWITALL's avatar

@jca I completely agree that the mentally ill need more help. My mom is very involved locally with National Alliance for the Mentally Ill. It is a huge problem, much neglected, and most funding is from States.

My mom’s office has free laundry facilities, Internet, free group sessions, a suicide hotline, etc… Basically they give the mentally ill somewhere to go where they are counseled by their peers and given access to resources they otherwise may not know about.

The shame is that they are a non-profit that rarely has money. They can’t advertise much, if any, because of lack of budget. It has helped many many people in our area, and I’m not sure why every single town in the States doesn’t have one of these.

Coloma's avatar

Crazy people do not think they are crazy, so, no seriously mentally ill person is going to sign up for therapy. It’s only the run o’ the mill neurotics that voluntarily seek intervention for their depressions and anxieties. The truly disturbed don’t think there’s anything wrong with them, it’s always somebody else, society, whatever.
Of course we need more free and afforadable counseling in this country, but, that doesn’t mean the budding psychopath is going to show up in private therapy and say ” Ya know, I have this urge to go to a school and shoot everyone in sight.”

KNOWITALL's avatar

@Coloma I completely disagree with your post, and think you are encouraging stigmatizing the mentally ill.

My mom is a group facilitator there, you would be chilled to hear her stories of what people have said to her about their feelings and impulses.

wundayatta's avatar

Well, health insurance would be a nice start. If we had a single payer health system, not only could we cover every resident of this country for everything, including full mental health benefits, but we could spend less than we do now.

That’s not going to happen.

Hmm. We could educate all the cops about mental illness and about better ways to relate to the mentally ill. Maybe the cops would take it seriously.

That’s not going to happen.

We could provide a full set of support services and information to families of people with autism spectrum disorders, and bipolar and schizophrenia and many other disorders.

That’s not going to happen.

I could go on and on about what the mentally ill would benefit from, mostly understanding, which of course, is the least likely to happen.

But really, there’s no point. These deaths will be forgotten soon. The mentally ill will be forgotten even sooner. No one really cares. Most people just want to live their own lives and these deaths happened far away in someone else’s elementary school. It won’t happen here, most people think. And most people are right.

This little paroxysm of navel gazing won’t have any effect on the country.

Hmmm. Should I talk about the homeless? Education? Housing? All are related.

That’s not going to happen.

Hawaii_Jake's avatar

Crazy people do not think they are crazy, so, no seriously mentally ill person is going to sign up for therapy. Really, @Coloma? How many crazy people do you know?

I am bipolar 1. In the circles I run in, we know we are hurting, and we know we need help. I talk to homeless people with mental illness and people with a bit more going for them. We all suffer.

And what is a “run o’ the mill neurotic”?

Why have any laws about driving for instance? Only the sane ones are going to drive correctly anyway. The drunks are just going to drive drunk no matter what we do, so why have laws against it?

To address the OP, we can make mental health available across the US in every city and town. We can do the same for health care in general, but wait. That’s socialized medicine. That’s Obamacare. That’s bad, or so many people would have us believe.

How do we accomplish nationwide mental health care? We make it a priority. We pay for it. Mental health has long been the dirty step child of health care, because it’s an invisible disease. It can’t be seen the way physical disease can.

KNOWITALL's avatar

@wundayatta Sadly I agree with you. Nothing will change because every time I mention the ‘big picture’ about our recession affecting the mental health of our people, it gets turned back to taking guns away, and I’m a ‘gun nut’. If you think losing your job and your home, your 401k and sometimes your family, your self-esteem, etc…doesn’t affect your psyche, then we have a nation of delusional people.

JLeslie's avatar

When I worked in a Behavioral Health hospital (nice way to say Psych hospital) the building with the most mentally disturbed people was kind of scary. Mostly housed Schizophrenics and manic bipolar people. Well, scary is too harsh a word, but the people were obviously less in control of themseves, it smelled like urine, walls were banged up a little, people yelled out at times, every so often some violent outburst happened (it was rare) but what I thought to myself was if my grandfather who was schizophrenic was but in there I would be upset. Even though I used to work in there, still my grandpa would not hurt a fly, and an aggressive person could easily hurt him. As an elderly man they probably would have put him in the geriatric building, but he was not old his whole life. Don’t get me wrong, the staff was not overly aggressve or abusive like you see in some movies. And, the campus was beautiful with trees and a lake, but everyone is locked in.

Still, if it were my son it would be hard for me to put him in there. Not to mention he was an adult, so the mother could not do much of anything, except call the cops if she really feared he would harm someone, and then maybe they would hold him for 72 hours. By the way other parts of the hospital were fine. We had children in one building, geriatric another, depressed in another, addicts another. People were quickly moved out of the building I described above as they became more under control so they could get some therapy, they would step down to a different building.

This young man who did the shooting was extremely smart, it probably would be difficult to know if he is going to for sure act out violently or not. Probably people suspected, but do we “jail” him for something he has not done yet? I think that is only done if a psychiatrist deems the danger as imminent. Sounds like it would be difficult practically to catch it before it happens every time.

elbanditoroso's avatar

@Hawaii_Jake – while you are probably right in everything you have said, you are living a pipe dream. Yes, we should make mental health care a priority in every city and town. Yes, we should pass laws and so on and so forth.

But that’s dreaming. There is no political will to make the dollars available to do this. They would rather buy guns and tanks and build bridges in Alaska than help the needy. We have seen that for 50 years.

Airplane manufacturers have better funded lobbyists than the mental health advocates do.

Bill1939's avatar

People would like to believe that antisocial behaviors only arise from the mentally deranged. However, the assumption that those who are severely mentally ill are more likely to act violently than are the rest of the population is false. Very little behavior is rational; that is, arisies from conscious cognition. Most acts are impulsive, generated by unconscious mental processes. Even when an individual develops elaborate plans to act destructively, their purposes are motivated by an accumulation of experiences that shape their impulses.

Most people would benefit from understanding their evolving motivations, which would enable greater cognitive interaction with their innate tendency to act impulsively. However, too few psychologists exist to be mentors for such education and society is not willing to pay for more professional training and employment. We are left with the unfortunate fact that the blind lead the blind, parents with unhealty psychological makeups shape the developing psyches of their children.

Laws and their enforcement will not resolve this problem. In a sense, the solution is spiritual. Religious practices will not create better psyches—religions for thousands of years have been the cause of violence and inhumanity. As the vitality of every organ, every cell determines the health of our body, we need a greater understanding that we are all one that the suffering of one afflicts us all.

wundayatta's avatar

Mental health issues are too hard and too complicated. People like to simplify things, but this can’t be simplified. All cases are individual and different and you can’t generalize a treatment from one person to the next. It is therefore too expensive and too resource intensive. So no one will be willing to pay the cost.

We could take away guns, but that involves another cost that people are unwilling to pay. So, in the end, losing twenty first graders from time to time is the cheapest option. At least, compared to taking away guns or actually dealing with mental illness.

It’s simple cost benefit analysis. Only we do it as a society. If there is any legislation passed as a result of Newtown, it will be so watered down by the end that it will do next to nothing. Until we are prepared to get serious about these problems, we won’t do anything serious. That means more deaths from more shooting. Maybe if we had ten shooting incidents a month for a year, we might get some action.

elbanditoroso's avatar

@wundayatta, To boil down what you said (and I happen to agree)

Life is cheap

The life of a 6 year old is cheaper than the life of an adult.

Judi's avatar

I can tell you that now, even if your destitute, if you ask for help they just look for ways to disqualify you. It’s tough. They say that if you see warning signs seek help but even if the patient is willing to accept help it often is not available.

Hawaii_Jake's avatar

@elbanditoroso I’m right, yet I’m living in a pipe dream. So, why have this discussion at all? We talk about matters like these, because this is how change happens in a democracy.

There’s no political will? Yes, there is. If every adult wrote their city, county, state, and federal officials, change would happen.

How did we found this nation? Did we start this country by sitting back and waiting for the powers that be to grant us rights? No, we took action.

And it’s time for action now.

@wundayatta Your logic is flawed, I believe. Cancer is complicated, too, but that doesn’t mean we don’t have nationally funded research into healing it. We got to the moon by tackling difficult issues. We can do this, too.

wundayatta's avatar

@elbanditoroso I’m saying that’s what Americans believe, on average. I do not personally endorse that position.

@Hawaii_Jake Cancer is your example? How far have we gotten since Nixon declared the war on cancer? There are a gazillion cancers and they are all different. Every time we get one (which isn’t often) ten more crop up. Yes, people can live longer with cancer, and it is a worthy place to put money, but do you seriously believe the American people will think mental illness is a place to invest in? Even after Newtown?

I’ve done political work all my life. I’ve been a starry-eyed idealist. Mental illness is the last thing most people care about. We’re crazy people, don’t you understand that? They don’t give a shit about us. They just want to sweep us into some corner that smells of urine and forget about us. Come on. You’ve been in that corner. Where do you come off being hopeful? Better to focus on trying to cope and build your own support network. This nation does not care and will not care, no matter how many times a hand or foot gets shot off.

KNOWITALL's avatar

@Judi There are also people so paranoid and filled with rage and hurt, they won’t ask for help from anyone. Those are the ones who scare me.

Coloma's avatar

@KNOWITALL
@Hawaii_Jake

Chill you guys….this is a fact amongst MANY unwell people. I have had first hand experience with several highly narcissistic and borderline sociopathic types, have read vast amounts about character disordered types, went to therapy to recover from my marriage to such a type of person, and it is very RARE for truly, seriously, potentially violent types to seek intervention.
For every highly disturbed person that is entertaining extremely dark thoughts that seeks therapy there are dozens more that do not.
In my experience, yes, EXPERIENCE, it is highly unlikely and most mental health professionals would agree.

So…the “problem” is, that short of going door to door and giving mental health evaluations to every man, woman and child, all the programs in the world cannot prevent these sorts of people from acting out against society. The only hope might be better education of parents and teachers to spot the potentially really disturbed early enough for some sort of intervention. This means before the age of 12, and even then, when it comes to sociopathology, at least, it’s all about brain abnormalities which no amount of therapy can change.

Coloma's avatar

To be perfectly clear, from my understanding of bi-polar conditions,it is not likely most will act out violently like a highly narcissistic or sociopathic personality.
You may have your mood cycles, self harm/suicide risk, but I am not talking about this sort of disorder, I am talking the severely psychopathic personalities.

Skaggfacemutt's avatar

As far at the tragedy in Sandy Hook, as a society we can’t possible prepare for or avoid every possible scenario. Who would ever think that a woman with a mentally ill son would think it a good idea to provide him with an assault rifle and teach him how to use it. And even if a thousand mothers of mentally ill sons did the same, it is likely that none of the others would do what this particular guy did. We do need to do something – but it’s hard to pinpoint what to do. These senseless acts of mass shooting are so rare and so random. I think a start would be to ban assault rifles. It won’t stop mass shootings from happening, but possibly make the shooter at least kill the people one at a time instead of a thousand in a second, limiting the carnage.

Skaggfacemutt's avatar

As a footnote to my comment – banning assault rifles won’t stop people from getting their hands on one, but I think in the last few mass shooting incidents that we have had – Sandy Hook and the Theater massacre in Colorado, that these particular shooters wouldn’t have had access to one. They were young guys, and not hooked up to underground gun dealers.

Hawaii_Jake's avatar

@Coloma Are you a trained mental health professional like a psychiatrist or psychologist? Do you know the criteria in the DSM-IV for narcissistic personality disorder or borderline personality disorder?

Can you give us some sources, please, to back up you sweeping generalizations about mental health professionals agreeing that for every one of their patients there are “dozens” who do not seek treatment?

We don’t have to go door to door to find those with mental illness. If we relieve the stigma surrounding mental illness, it’s my opinion that more people will seek help.

Coloma's avatar

@Hawaii_Jake I was married to a diagnosed NPD and that is my “source.” My “sources” include my old therapist and many, many, publications. A great source is ” The sociopath next door ” by Martha Stout and “The PDI disordered individual” by ” Stan Kapuchnski MD/PhD” and others I would have to look up. It is stated VERY CLEARLY that these people RARELY take responsibility for thier issues and the odds of change are about zero in the big picture.

My ex is a classic NPD/SPD corporate type and trust me, my adventure into therapy and my vast studies of these types has been one of the most enlightening undertakings of my life. I was the victim of this type of person and so, obviously, I do know of what I speak given firsthand, up close, and personal experience.

Seek's avatar

Another vote for single payer healthcare as a start.

I come from a family with rampant mental illness. I have Depression, my brother is bipolar. Pretty sure sister has Depression as well. Both parents are clinically depressed and mother is prone to panic attacks.

It would have been nice to be able to get my brother in to be seen and diagnosed before he went manic at 19, downed most of a bottle of Advil PM and half a bottle of Sambuca and sat in the food court at the mall slashing his own shoulders with a pocket knife. I’m just glad he’s self destructive, because the master plan brewing in his brain was a lot worse than that.

It wasn’t until four years later that the Army doctors diagnosed him bipolar. And now, because he has been medically discharged, he can’t find a job, is so far ineligible for unemployment, and can’t afford to stay on his meds.

Yay, America.

KNOWITALL's avatar

@Coloma Please don’t tell me to chill out, I am perfectly calm and this is a public forum.

@Hawaii_Jake My mother was finally diagnosed as bi-polar at age 55, after nearly drinking herself to death trying to find relief. Perhaps mental health professionals and general practice doctors need more education on the subject, too.

@Seek_Kolinahr I’m so sorry to hear that, what a horrible situation.

Hawaii_Jake's avatar

So, since nothing can be done in the big picture to answer the OP, we shouldn’t try anything at all, @Coloma? This question is about what we can do as a nation to change a broken system, and what I’m reading in this thread is that nothing can be done, so let’s move on.

We used to have lax drunk driving laws. Did that stop MADD from campaigning to change those when things got out of hand? No, they took up arms, raised awareness, and got laws passed with stricter penalties for drunk driving.

We have an opportunity in the days following this tragedy to begin dialogue about changing access to guns designed for slaughter and opening access to greater mental health care.

Coloma's avatar

@KNOWITALL I only responded to your immediate defensive energy. As the victim of a highly disturbed person I don’t appriciate my knowledge and experiences being minimized. You can disagree, but wait until you have all the facts.

KNOWITALL's avatar

@Coloma My post was explaining about mental health facilities and what they provide, what is defensive about that?

I was a victim, too, so why can’t we both share our feelings and observations? Do you think being raised in poverty by a single bi-polar mother with extreme mood swings, manic depression and intense drug and alcohol use wasn’t traumatizing? Do you think when she got drunk and hit me and never remembered that I felt loved?

My mom got diagnosed, on meds, and started helping others immediately. She volunteered and learned, then took classes worked there, then dedicated her life to helping others get better because of her own experiences. They go to Jefferson City trying to change things.

The fact is that getting help probably saved her life, and possibly the lives of others she would have endangered or killed. So this is very important to me and I feel confident that my experience with her and others at the center qualify me for a discussion. Thank you.

Coloma's avatar

@KNOWITALL Agreed, and likewise. I’m just saying that it IS true, the vast majority of really disturbed people do not seek intervention and are incapable,by the sheer depth of their pathology to even entertain such. Lets move on, and I will pay attention to my passionate feelings on this subject as well. I will say though, that I will always be on the side of the victims, no matter how much compassion I can muster for the mentally unwell, their victims take precedence IMO.

Coloma's avatar

@Hawaii_Jake Well, sadly I think it is true, not much CAN be done, except educate people about the red flags of a potentially very dangerous person. The usual, history of violence, bullying behaviors, animal abuse, fire starting, conduct disorders….wave those flags wide and high.

Skaggfacemutt's avatar

So I am having a hard time following what we are really discussing here. Are we talking about our health care system? Yes, we need to get medical care for the mentally ill. We are doing that now for those who can pay, and whose families get them in for treatment. We are working on the problem of those who can’t pay. I don’t know what we do for those who don’t seek treatment and whose families don’t alert anyone to the problem. A socialized health care system would also weed out the millions of people who feign emotional and physical problems just for the drugs or the attention. My daughter, who works for a Physical Therapist, reports that most of her patients are bored housewives with good insurance who have been coming in every week for decades, just for something to do.

Skaggfacemutt's avatar

BTW: As far as these mass shootings, this is the first one carried out by someone who had been identified as mentally ill, so I don’t get the relevance. The mass shooting in Salt Lake City was carried out by a Bosnian refugee. So, should we institutionalize all Bosnian refugees?

Hawaii_Jake's avatar

I’m sorry you were in a bad position in respects to your ex, @Coloma.

The OP wants us to discuss how the latest tragedy may enable national dialogue about increasing access to care for people who need it.

I want individuals in the US to have an open mind to discussing mental health. Currently, that doesn’t seem to be what’s happening. People with mental illness are viewed as violent, bullies, abusers, fire starters, etc.

Not all of us are like that. Not all persons diagnosed with mental illness are violent.

Coloma's avatar

@Hawaii_Jake I agree wholeheartedly. As always, degrees.
I, personally, don’t even remotely, equate your particular condition with the topic at hand. The bipolar apple is not the sociopathic Orange. :-)
The traits you mentioned are associated with the potentially, extremely violent offenders though.

bookish1's avatar

So does anyone know what this guy was actually diagnosed with?

Skaggfacemutt's avatar

He was diagnosed with Aspergers and a possible dose of autism. But, from what we are hearing about his symptoms, he sounds pretty messed up. As a 10-year-old, his mother told a babysitter to not turn her back on him even for a second, not even to go to the bathroom. What does that tell you?

My daughter’s boss has an adopted son who is extremely messed up because his birth mom was on drugs (anyway that is what the doctors attribute it to). He has tried to kill his sister, and the dog. He is totally out of control and was even in the state hospital for a while, even though he was only 7. I worry about him. His extreme problems have so far caused his parents to divorce and his sister to leave. If ever there was a train wreck waiting to happen, it is this kid! He is 14 now and extremely dangerous, yet he is out there in society as his mom tries to pretend nothing is wrong. So what is the solution when Mom is in denial and kid is a budding Teddy Bundy.

KNOWITALL's avatar

The number of parents feeling threatened by a child is rising dramatically. Even locally that is one of the biggest complaints/ fears in groups.

bookish1's avatar

@Skaggfacemutt : Thanks for your response. This is what I had initially heard and I was wondering if more information had been obtained… Because I really did not think that autism was considered a mental illness…. O_o

Bill1939's avatar

The media has grasped every nugget of information provided by authorities, expanded upon it, and offered it to the public as fact, even though it seldom was more than official conjecture which often later proved to be false (for example, the perpetrator, how he entered the school, his mother’s involvement with the school, his mental history…).

It is as though if we had reasons for this horrendous act we could somehow prevent future occurrences from happening. Frankly, even if we had an entire explanation for this specific event, I doubt that it would have much of a predictive value, much less a preventative one.

Skaggfacemutt's avatar

@Bill1939 I agree with that. Every mass shooting has been a different set of circumstances, totally random, and there is really no common denominator that we can address – other than, maybe, the assault weapons. Only one shooter was mentally ill, only one was a refugee, only one was bullied at school, and then there was one who was none of the above.

JLeslie's avatar

@Skaggfacemutt Asperger’s is on the spectrum of Autism, it’s not really correct to say a dose of autism added. It’s kind of a mild form of Autism so to speak.

I assume he is actually a dual diagnosis.

Skaggfacemutt's avatar

Thanks, @JLeslie , out of curiosity I looked it up after I wrote the above comment, and you are right. But whatever his diagnosis was, his mother was well aware of symptoms, which were far more severe than Asperger’s would explain, and she still thought it was a good idea to give him an assault rifle. It makes me think that all of us are at varying degrees of “crazy” or “stupid” and it’s amazing that these tragedies are as rare as they are.

JLeslie's avatar

@Skaggfacemutt I think you make a very good point. I have a friend whose son has been diagnosed with some sort of defiant disorder when he was very young, and later with ADHD. He takes meds for the ADHD and they help a lot. Anyway, at a young age hos grandma said to his mother, “that kid will either be incredibly successful or be a criminal.” He was a gorgeous child and a charmer, but a total pain in the ass. I think his mother would be freaked if the kid had access to firearms.

YARNLADY's avatar

I knew a five year old who showed dangerous tendencies. His mother advised me to watch him very closely around my baby. It’s sad and scary, but there doesn’t seem to be any solution.

Hawaii_Jake's avatar

Why doesn’t there seem to be any solution, @YARNLADY? The US is a country that is built on holding great national debates and finding solutions to problems.

We had a revolution as the result of a national problem. We worked out a form of national governance with our Constitution when our first Articles of Confederation didn’t work. We ended slavery through a bloody Civil War. We beat down the autocratic robber barons of the late 19th century and saw the rise of unionized labor and laws instituting safer working conditions. We brought about a more just society through desegregation.

We worked through those challenges. Surely, we can work through the current ones, too.

Bill1939's avatar

@Hawaii_Jake, too little is known about human behavior. History is replete with failed attempts by civil and religious authority to motivate people to act in ways that promote peace and tranquility. Never before has it been as possible as it is now with instant electronic communication for such a debate as you suggest to transpire. But will talk change human nature? Reading many of the comments above leads me to feel that it has all been said before to little avail. An oppressed and/or exploited people will alway slip into their primal animalistic self. Survival of the body and psyche require that they do so.

burntbonez's avatar

There are plenty of ideas and solutions. They just cost too much and seem to benefit too few people who mostly are crazy and homeless and therefore are of little interest to normal citizens. I think most people are happy that the mentally ill end up in jail rather than hanging around on streets scaring children. That way, normal people never have to think about the crazy ones.

Hawaii_Jake's avatar

I guess I’m not as cynical as some of the posts seem to be in this thread. I think real change is possible after the latest incident.

Should we allow past failures to dictate present debate? No, I believe we should look at past triumphs to guide our ideals.

YARNLADY's avatar

@Hawaii_Jake Unfortunately, solutions cost more money than society is willing to pay, starting with funding to find out how the brain works.

Plus, do we really want to find a method that will control how people think/act? How do we know it would be used only to deter potential criminals. What if it was used to control aberrant behavior as well
_ Aberrant_ to be determined by popular vote or ?.

Hawaii_Jake's avatar

Let’s look at the OP, @YARNLADY. It’s asking us to find treatment solutions for the severely mentally ill. As a nation, we can make it a priority. Where there’s a will, there’s a way. I believe that now is the time to talk about such matters.

It seems to me that as citizens, it’s up to us to begin that dialogue. I see that happening all over the place right now. Here, other sites online, news sources, discussions in cafes, and many more are all buzzing with talk about how to change the culture of violence we have.

Personally, I have every reason to be a cynic about questions related to cultural change. I’m poor. I’m gay. I’m mental ill. I’m alone. Yet, I have hope for the country.

I don’t believe that helping people with mental illness will lead us down a path to controlling how people think. We already have laws about how we act. Laws govern actions, in my opinion.

wundayatta's avatar

I think that being cynical is a reasonable strategy for pushing for action. It’s a kind of reverse psychology. It would be so easy to stop this problem. It only takes a little bit of health insurance so everyone can get access to affordable care. But we’ve been fighting that battle for many decades now, and gotten nowhere, ACA, notwithstanding. People have a choice. They can do nothing because it is too expensive (which it really isn’t), or they can do the right thing. But of course, they won’t do the right thing. It’s too expensive.

Now many some people will feel that it would be worth the cost, knowing that there is much we can do. But I seriously doubt it. It hasn’t worked in the past. Why expect people to be different now?

Hawaii_Jake's avatar

Cynicism is an attitude or state of mind characterized by a general distrust of others’ apparent motives or ambitions, or a general lack of faith or hope in the human race or in individuals with desires, hopes, opinions, or personal tastes that a cynic perceives as unrealistic or inappropriate, therefore deserving of ridicule or admonishment. It is a form of jaded negativity, and other times, realistic criticism or skepticism. (From Wikipedia’s entry entitled “cynicism (contemporary)”. For some unknown reason, I can’t get it to link to work correctly.)

With this definition in mind, I don’t think being cynical is appropriate for advocating change. It points toward the opposite, which is stasis or inactivity.

The ACA or “Obamacare” is a perfect example of change. Some type of health care for all Americans has been talked about since Teddy Roosevelt. Many people said it would never happen, but it did. It is reality. It is the law of the land.

There are a few posts in this thread saying things haven’t worked in the past, so they won’t work now. I’d like to know what hasn’t worked in the past?

It seems to me that plenty has worked in the past. There are a multitude of events to point to that have worked.

Coloma's avatar

Okay…here’s the solution. Lithium in the water supply. Done. haha

wundayatta's avatar

Health care reform. We’ve pushed for single payer for decades. Now we have the ACA. It costs a horrendous amount, wastes money left and right, and doesn’t cover everybody. I would not say that it is working. Yes, it’s better than before, by a little bit. But it is a pale shadow of real health care reform. It won’t work. Then the conservatives will say see, this is why we need the free market. This is why we need to get rid of it. And they will destroy what was good, and replace it with things that are far more hurtful.

YARNLADY's avatar

Ah, the solution is for each family member to take responsibility for their fellow family members, and see that they receive the proper treatment and care. This needs to be done in every family, in every case.

jca's avatar

@YARNLADY: What about people without family? What about people who have alienated their family (as many severely mentally ill do)?

kitszu's avatar

The question is how do we balance our societies security without trampling individual rights.

This is a slippery question with scary potentials and no “right” answers.

The Patriot Act. Why did we as Americans vote for it? Why, do we, as Americans (those of us that do) now have concerns about the way it’s being used?

potential Immediate danger seems like it might make even rational people make bad choices.

Pandora's avatar

I really don’t know but I wish they would at least make it impossible for them to every get their hands on guns or at least make guns with some sort of chip that disables the weapon when near a school or a chip that will alert cops when you are near a school and give your location.

YARNLADY's avatar

@jca If the family abdicates their responsibility, they should be required to pay for the public to do it for them. If there is no family, then the public must get involved.

jca's avatar

@YARNLADY: That’s a big stretch. “Pay for the public to do it for them?” Potentially hundreds of thousands of dollars for tracking, treatment, etc. Who has that kind of money to spare?

YARNLADY's avatar

@jca In the old days, when there were still State run mental hospitals, my brother was committed to the hospital, and my parents received a bill every month, which they had to pay.

My husband’s insurance policy covers mental illness.

jca's avatar

@YARNLADY: Yes, I know many insurance policies cover mental illness but there are two problems with that – 1 is that many policies have limited coverage for therapy and they often all have copays, and 2 is that the policies don’t cover extended family (like brothers as you cited in your example). Plus, in your example of your family paying for the hospital every month, that was probably way back when. Now, institutionalization and medications can be thousands of dollars a month. Who has that kind of money now? Most people can barely make ends meet, even those with good jobs. People have mortgages, and those with college tuition to pay already are paying 40k and up per year for that.

Bill1939's avatar

A group of medical professionals made a suggestion that makes sense to me. Ban ammunition that shatters on impact, sending shards throughout the victim, from civilian purchases. Such bullets are worthless for hunting.

It seems to me that the profit motive for providing health care, particularly for drugs and corporate hospital costs, is responsible for excessive expenses to consumers. Imagine what services by police and fire departments would cost the public if they were for-profit.

bkcunningham's avatar

I read that Adam Lanza’s mother, Nancy Lanza, was at her wit’s end and was having him committed to a psychiatric facility and that is what pushed him off the deep-end. I don’t believe, from what I’ve read, that the family wasn’t able to get him mental health services.

JLeslie's avatar

@bkcunningham Interesting. I had been thinking about how people with behavioral problems, and especially those with some anger and range, can have devastating reactions an extreme change in circumstance or when someone tries to restrict them. Examples would be a woman leaving a very violent controlling husband. There is a statistic of women being killed when she finally leaves or gets a restraining order. Another example is when a person is acting out a little, when someone tries to physical restrain them they really freak out. I always was empathetic to that, because when you feel out of control, how awful to have physical restraints, it’s awful even if we are in control. I spoke about a friend of mine who has a son who is very difficult to deal with. She was advised to hold him tight when he is out of control until he relents. I found that difficult to watch the one time I saw it. I don’t know whether to think it helped him, or if it just demonstrated to him he can’t win, because he is small and weak right now. But, it must have pissed him off? What happens when he is bigger and stronger? She used to put him in his room also until he calmed down, I guess similar to time out.

bkcunningham's avatar

@JLeslie, have they diagnosed your friend’s son? I’m curious what his diagnosis is and what medications he is on. I don’t want to offend anyone, I have a brother who is a paranoid schizophrenic and a sister who is bipolar. I know all to well the hardships on a family with a loved one who has a mental illness. I am always amazed at the number of people I meet or talk to who have been diagnosed with some form of “mental illness” and are on medication. They see their therapist and only see a trained psychiatrist once a month to get their prescriptions written.

Coloma's avatar

Well, I absolutely believe in the “bad seed” factor. Holds true for sociopaths for sure.
It also holds true for animals. I had a mentally deranged dog once I had to euthanize at age 5 for aggressive behavior.

His breed is known to be of a happy, goofy, and stubborn nature, ( he was a large hound ) but not human aggressive.
I interacted with his mother when choosing him and she was a shining example of the breeds temperament standard. I put him in puppy and obedience classes, socialized him properly, never was abusive to him in any way, and he was exhibiting extremely aggressive behaviors at 4 months old!
By the time he was 5 he had shown himself to be very untrustworthy around anyone,including family members and he bit ME as well as my brother-in-law at the time.

My daughter was about 7 at the time and I couldn’t risk him biting her or other children and certainly could not re-home him due to his unpredictable nature.
Sadly I felt the only option was euthanasia.
Broke my heart and I joked forever about feeling like the mother of a serial killer.
I did EVERYTHING for that dog and he still turned out evil!

JLeslie's avatar

@bkcunningham When he was very very young, around the age of 3–4 I think, he was diagnosed by one therapist as being oppositional defiant disorder or something like that? I might have it wrong. Later ADHD. He is on ADHD medicine, I don’t know which one, and it helps tremendously. Although, the medicine reduces his appetite so it is always a struggle to keep him eating well and to keep his weight up. He is about 10 years old now.

One interesting thing that happened was he had been in private preschool and K, maybe 1st grade too, and when he was going into first or second grade, she thought about moving him to public school for mostly money reasons, and I told her to do it. My gut feeling was this school had seen him at his worst at a very young age, and he was pegged as the bad kid. It was very difficult for her, but she did put him into public school, and there was a significant change. He did much much better behaviorally. I am not saying public is better than private, I am only saying a fit for a particular child can make a difference. Might be private, public, or homeschooling, I don’t favor one over the other. It’s possible a change to a different private school might have acheived a good result also.

He is much better. Between the drugs and simply getting older he is much more in control.

bkcunningham's avatar

Yes, the ADHD diagnosis seems to be increasing. It is interesting to me that boys are more likely than girls to be diagnosed with ADHD.

JLeslie's avatar

@bkcunningham I think it is overdiagnosed and misdiagnosed a lot. But, for this kid it seems to be accurate. It makes sense to me boys get the diagnosis more often. They are generally more active than girls. I think some of our expectations for boys to sit still at very young ages are not appropriate.

bkcunningham's avatar

I agree with you 100 percent, @JLeslie. I’m glad your friend’s son is doing okay now and received the proper treatment and support.

Coloma's avatar

Also personality typing enters into it. I am a female ENTP ( extroverted-intuitive-thinking-perceiving ) and we are known for our very fast brain processes, high energy and ability to rapidly skip from topic to topic often making connective associations others miss entirely. This temperament also gets pegged as ADD/ADHD a lot, when in reality. it is the perfectly natural way that our brains work. ENFP’s also get this diagnosis. So, my point is, a lot of these diagnoses are often the result of an individuals unique brain processing style as well.
Many factors go into making a valid diagnosis.

I was often restless in school and still am when required to remain still and attentive of subject matter I consider boring, repetitious and often master and absorb at a rate about 10x faster than most.
Many exceptionally bright children get pegged with the ADD/ADHD label when they are simply just FASTER at processing information and then lose interest quickly.

janbb's avatar

It feels like this thread has been highjacked but is that just my opinion?

JLeslie's avatar

@Coloma Losing interest is different, but I understand where you are coming from with the mistaken diagnosis. I worked for a woman who within a few days I told my husband she must be ADD. Not many weeks later she told me, it wasn’t really something she tried to hide. She could not focus on one thing for too long, it had nothing to do with interest level. Tons of kids are not interested in topics, but they are not hyper nor jumping from one thing to another. ADD kids cannot stay focused even on subjects they are interested in. At times they can, but there is an overall pattern of their attention span not falling within what society today considers normal.

All mentally ill people could say other people don’t understand how their brain is wired.

@janbb Maybe? The discussion seems be centered on mental illness, diagnosis, and what to do? Trying to figure out which members of our society are at risk, and put everyone at risk in turn.

Coloma's avatar

@JLeslie I agree, just sayin’ that personality and temperament also factor in when trying to determine these issues. :-)

jca's avatar

@bkcunningham: I’m sure Adam Lanza’s mom had access to mental health services, but how does someone like her make someone like him (an age where he is legally independent) go to therapy if he refuses? Even if she got him there once or a few times, how does she ensure that he continues and complies?

bkcunningham's avatar

I don’t know, @jca. I think the answer is, you can’t. It doesn’t matter how fabulous your insurance nor how miraculous your doctors. You can’t make someone get help if they don’t want it unless they are a threat to themselves or others. From what I’ve read, she was in the process of having him committed, which is the only answer I can see from the outside looking in. That route didn’t work.

What do you think?

Coloma's avatar

@bkcunningham I agree, nothing that can be done, unless, as you mentioned, the person is deemed a threat to self or others. Clearly, too late for the Lanza family and everybody else.

wundayatta's avatar

She was working on having him committed? Any links for that information?

I wonder if it would have made a difference if she had been warned that if you have someone you want to commit in the house, you shouldn’t have firearms in the house. They should be locked up somewhere else (if you lock them up in the house, and you have the key, it is always possible for someone who is not licensed to have them to get the key and gain possession of the them).

If she had been told that, would she have followed that advice? I seriously doubt it. But maybe in the future, more people might worry about these things.

JLeslie's avatar

@wundayatta I doubt it too.

jca's avatar

@bkcunningham: I think you and I are on the same page, which brings me back to my question. What can be done to ensure taht people ge tthe help they need? The way the system is now, it appears nothing or very little.

Skaggfacemutt's avatar

The hardest thing for society to accept is that there are many things that are out of our control. Rounding up all the potentially dangerous people is one of those things.

wundayatta's avatar

Thanks, @bkcunningham.

I will say that I don’t believe in forced committment for mental health care, and that is partly why. The other part is that I don’t believe it does any good unless a person chooses to get treated. I know some people believe that some mentally ill people are so badly off they can’t recognize they need help, and once they get treated, they recognize it and cooperate.

But I don’t think that happens very often. Mostly I think mentally ill folks pretend to cooperate because they want to get out asap. And when they do get out, they stop taking their meds because they simply don’t trust the mental health establishment.

If Adam Lanza was afraid of being pushed away from his mother, then everything she did confirmed that. It’s as good a story as any. He was always different. He always felt isolated. Probably his mother was the only person in the world he felt remotely close to, except for a few gaming buddies.

The problem, I believe, is love. We all need love. We need to feel connected. If we can’t feel connected we slowly go crazy—getting depressed and angry and more and more isolated. Some people will snap.

Can we find a way to provide love and connection to people? Especially those who seem the most isolated? I don’t know. I think support groups can help.

bkcunningham's avatar

It does depend on the severity and type of mental illness, @wundayatta, but I can see where there is something to your conclusion. Even if it is a support group for the family and a way to give them freedom and give supervision to the mentally ill family member. I remember an organization back home that I was always so impressed with that did just that. It was a volunteer respite care program. Family members volunteered and took turn about giving one member a day off while the others in the group did an organized activity with the mentally ill family members.

It was amazing and I knew several people who participated. The entire program got taken over by a state agency and has grown leaps and bounds and offers a vast array of out patient mental healthcare programs for the families and the person facing mental health issues and challenges. There is even employment opportunities for the “patients.” It isn’t perfect, but it is a wonderful program that grew out of pure love.

wundayatta's avatar

Well that sounds wonderful, @bkcunningham.

Judi's avatar

I had a conversation with someone today about personal respinsibility. They were saying that people who do these things bear the responsibility themselves.
I told her that I didn’t totally agree.
If a house is infested with mold and someone gets sick from the mold it is easy to agree that the mold caused the illness.
If the homeowner knew that there were leaks and poor ventilation and knew that mold was growing and did nothing about it then the homeowner bears some responsibility for the people in the house getting sick.
The shooter is the mold. Totally responsible for the illness. Our society and our culture are the homeowners. We have a responsibility to create an environment where mold can’t grow, or if it does, treat it and correct the cause before it gets out of control.
We can support individual responsibility, but in reality we are our brothers keeper.
I should add that I don’t know how we do this, but I think that this is where the conversation should begin.

wundayatta's avatar

I like that analogy, @Judi.

Yetanotheruser's avatar

@Judi That is a wonderful analogy. I also do not know how to do this. I guess the question now morphs to how do we get this conversation started in the general public, the mental healthcare community, the media, the politicians, all those who are able to engage and make the necessary changes? Where do we go from here?

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